高敏受者肾移植术前行血浆置换的临床探讨

目的 :探讨高敏受者肾移植术前行血浆置换 (PE)的效果。方法 :12例高敏受者在肾移植术前进行PE治疗 ,37例高敏受者未行PE治疗 ,观察两组肾移植病人排斥反应发生率的差异。结果 :PE组置换前PRA值71.0 %± 19.1% ,置换后 34.3%± 17.9% ,两者有显著性差异 (P <0 .0 1)。术后发生超排 2例 ,急性排斥 2例 ;未行PE组发生超排 2例 ,急性排斥 8例 ,两组间超排和急性排斥的发生率均无显著性差异。结论 :PE对预防超排和降低急性排斥的发生率均无明显作用。PE治疗的主要适应症为PRA大于 80 %的受者 ,能快速降低PRA值 ,有助于HLA抗体特异性分析和HLA配型。     

血浆置换治疗97例重型肝炎并发症的防治

目的探讨血浆置换治疗重型肝炎时并发症的发生原因及防治措施。方法回顾血浆置换治疗97例重型肝炎时出现的并发症的有关资料，分析各种并发症发生的原因。结果26．6次治疗中共出现并发症131次，发生率达49.3％。按发生率高低依次为皮疹、麻木和（或）搐搦、血压下降、胸闷、失衡综合征、置管处渗血、体外循环凝血及置管处渗液。结论血浆置换治疗重型肝炎时并发症的发生率高，但经处理均能缓解，可以在严密监护下实施。     

A reevaluation of the status of cholesterol in erythrocytes infected by Plasmodium knowlesi and P. falciparum

The cholesterol synthesis of rhesus monkey erythrocytes parasitized by Plasmodium knowlesi and human erythrocytes infected by P. falciparum, as measured by incorporation of [1-¹⁴C]acetate and ³H₂O, was almost undetectable, concordant with very low levels of measurable 3-hydroxy-3-methyl glutaryl-CoA reductase activity. In addition, both types of infected cells exchanged cholesterol with the plasma at the same rate as uninfected cells. The data do not exclude the possibility of cholesterol transfer from uninfected to infected cells.     

Characterization of acetate uptake by the colonic epithelial cells of the rat

The characteristics of acetate uptake by colonic epithelial cells of the rat were studied. Clear saturation kinetics of acetate uptake were not observed in these experiments at either 0° C or 30° C. A decrease in the pH of the medium markedly increased the acetate uptake. The activation energy for acetete uptake derived from an Arrhenius plot was about 6.1 kcal/mole. Among the inhibitors tested, no effective inhibition of acetate uptake at 0° C was observer. Metabolic inhibitors severely inhibited transport at 30° C. Inhibition of acetate uptake by other short chain fatty acids, which was non-competitive, was observed. The finding that efflux from the cells was stimulated in the presence of compounds such as pyruvate and bicarbonate supported the notion of a close interrelationship between weak electrolyte transports in vivo. Although the H⁺ gradient across the cell membrane is suggested to be one of the factors determining the uptake rate, it seems difficult to explain all the results in this way.     

曲马多药树脂速释混悬剂的研制

为掩盖盐酸曲马多的苦味 ,并达到迅速镇痛的目的 ,利用盐酸曲马多与离子交换树脂结合制成药物树脂的制备方法 ,进行了曲马多药树脂速释混悬剂的研制实验。实验结果表明 ,该制备方法简单 ,研制出的曲马多药树脂速释混悬剂稳定、口味好、释放迅速     

外周动静脉同步换血对血清钙的影响

目的：探讨外周动静脉同步换血对血清钙的影响。方法：对２５全高胆红素血症患儿采用同型血进行外周动静脉同步换血,换血前后在同一动脉端取血测血清钙。结果：换血过程中应用钙剂组（观察组）与未应用钙剂组,血钙水平在换血前后及两组之间均无差异,Ｐ〉０．０５。注射钙剂的不良反应发生率为６．２５％。结论：外周动静脉同步换血疗法对血清钙无明显影响,换血过程中静注钙剂是不必要的。     

利用RNA干扰技术下调Lon基因表达的生物学效应研究

目的:通过构建Lon基因下调的哺乳动物细胞模型表达,观察Lon基因对肿瘤细胞增殖及凋亡的影响,以探讨Lon蛋白的功能.方法:设计针对Lon蛋白酶的小干扰RNA(siRNA),构建pSilencer U6 2.1-Lon真核表达载体,用脂质体法转染人乳腺癌细胞MCF7,RT-PCR检测Lon基因下调的水平,通过采用高温、紫外线照射、顺铂处理,观察Lon基因下调后细胞敏感性的变化(MTT法).结果:RT-PCR显示重组质粒pSilencer U6 2.1-Lon转染MCF7细胞,Lon基因明显下调,RT-PCR未见扩增目的带,细胞培养结果显示,细胞增殖能力明显减弱.紫外线照射和顺铂处理后的MTT结果显示,pSilencer U6 2.1-Lon转染的MCF7细胞,增殖能力明显下降,与空载体转染组(pSilencer U6 2.1)和未转染组相比有显著性差异(P＜0.05).加热应激试验显示,37,41,43℃处理后,RNA干扰转染组(pSilencer U6 2.1-Lon)与空载体转染组、未转染组相比有显著性差异(P＜0.05).而在45℃时,RNA干扰转染组、空载体转染组与未转染组之间均无显著性差异(P＞0.05).结论:RNAi能有效下调Lon蛋白的表达.Lon基因的下调可抑制乳腺癌细胞MCF7的增殖能力,诱导细胞凋亡,以及可增加MCF7对紫外线和顺铂处理的敏感性.     

换血疗法在新生儿高胆红素血症中的临床应用

在各种病因的作用下,新生儿体内胎儿型红细胞破裂,向血液中大量释放胆红素,所产生的临床综合征即为新生儿高胆红素血症,其发病率逐年上升,可导致新生儿神经系统损伤、智力发育异常等。新生儿高胆红素血症换血疗法(BET)虽在世界发达国家临床应用逐渐减少,但从我国对其使用状况来看,BET仍然是治疗新生儿高胆红素血症的有效方法之一,可快速有效降低体内胆红素水平。现就BET治疗新生儿高胆红素血症现况作一综述。     

Brief communication: The Mid-South Clinical Data Research Network

The Mid-South Clinical Data Research Network (CDRN) encompasses three large health systems: (1) Vanderbilt Health System (VU) with electronic medical records for over 2 million patients, (2) the Vanderbilt Healthcare Affiliated Network (VHAN) which currently includes over 40 hospitals, hundreds of ambulatory practices, and over 3 million patients in the Mid-South, and (3) Greenway Medical Technologies, with access to 24 million patients nationally. Initial goals of the Mid-South CDRN include: (1) expansion of our VU data network to include the VHAN and Greenway systems, (2) developing data integration/interoperability across the three systems, (3) improving our current tools for extracting clinical data, (4) optimization of tools for collection of patient-reported data, and (5) expansion of clinical decision support. By 18 months, we anticipate our CDRN will robustly support projects in comparative effectiveness research, pragmatic clinical trials, and other key research areas and have the capacity to share data and health information technology tools nationally.